Despite the risk, it's important that women maintain effective epilepsy control during pregnancy, because seizures can also harm the fetus. The risk of birth defects may be different among women taking topiramate to treat migraines, but these women should be monitored as well, the researchers said.
Dr. Orrin Devinsky, a professor of neurology, neurosurgery and psychiatry, and director of the New York University Epilepsy Center, said this study underscores the need for all women of childbearing years who take antiepileptic drugs to discuss preconception planning with their physician.
"All women should clearly understand the risks and benefits of their therapy," Devinsky said. "Until more information is available, topiramate use in women who plan on conceiving should be restricted to those in whom the drug is definitely needed for seizure control or other indications. Also, the mother should be informed of the potential risks to her child."
Another epilepsy expert, Dr. Edward Barry Bromfield, chief of the Division of Epilepsy at Brigham and Women's Hospital in Boston, agreed that women should be warned about the potential side effects of the drug.
"Women with epilepsy, if they depend on this drug to control their convulsive seizures, they should definitely continue it," Bromfield said. "If they are taking it for migraine prevention, chances are they would want to discontinue it before conception," he said.
For more on epilepsy, visit the U.S. National Library of Medicine.<
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